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Fraud Crimes/federal Insurance Fraud Lawyers
Fraud Crimes / Federal Insurance Fraud Lawyers
If you’re on our website, it’s because you’re in serious trouble and need a reliable federal insurance fraud lawyer. At Spodek Law Group, we understand the gravity of your situation—and we take it personally. Our team has over 50 years of combined experience handling state and federal cases. We’ve seen how prosecutors come after defendants when they believe fraud has occurred. We know how to fight back, and we’re here to give you the best possible legal representation.
Why Federal Insurance Fraud Cases Are Different
Federal insurance fraud goes beyond simple misunderstandings on an insurance form. If the alleged fraud involves interstate claims, federally regulated programs, or large insurance entities, federal prosecutors usually jump in. These prosecutors have vast resources, and they’re not afraid to use them. That’s why having a top-rated federal defense attorney is so critical. Federal statutes—like 18 USC § 1347 for healthcare fraud or 18 USC § 1033 for crimes affecting those in the insurance business—carry severe penalties. Fines can be astronomical. Sentencing guidelines can result in long prison terms.
Our Approach at Spodek Law Group
Our criminal defense attorneys have been recognized by major news outlets for good reason. We work tirelessly on behalf of our clients. We have offices throughout Long Island and NYC, but we handle tough legal issues nationwide. Our mission is to investigate your situation thoroughly, craft the strongest possible defense, and pursue every avenue to get charges dismissed or reduced.
We pride ourselves on total transparency. We also have a cutting-edge, digital portal where you can communicate with our team, see your invoices, and access confidential documents virtually. We’re here 24/7 for a free consultation. When you’re accused of insurance fraud, there’s no time to waste.
The Key Laws and Penalties You Should Know
• 18 USC § 1033: Governs crimes involving the business of insurance. That can include misappropriating premiums or lying on insurance applications.
• 18 USC § 1347: Focuses on healthcare fraud. Overbilling for services, submitting false claims, or exaggerating diagnoses can spark major federal investigations.
• Federal Sentencing Guidelines: The penalties for fraud can escalate sharply depending on how much money is involved, the number of alleged victims, or if you have prior convictions. Judges often follow these guidelines closely, which is why you need a strategy that challenges every assumption.
Common Misconceptions
Many people incorrectly assume double jeopardy shields them if they’ve already faced state-level charges for the same conduct. That’s rarely how it works. The federal government is a separate sovereign and can pursue its own case—even after a state prosecution. In these moments, you need a defense lawyer who fully understands how parallel investigations operate.
Real Defense Strategies We Explore
- Lack of Intent
In federal fraud cases, the government has to prove you acted with criminal intent. If we can demonstrate you made an honest mistake—like a billing error or a miscommunication with your insurance carrier—that can be a game-changer. Imagine a physician who is juggling multiple coding protocols for billing Medicare. If the coding system itself was flawed, that weakens the argument of willful fraud. - Entrapment
If federal agents coerced or encouraged you to commit a fraudulent act you wouldn’t have committed otherwise, entrapment might apply. While it’s not an everyday defense, it’s powerful when the facts line up. For example, if an undercover informant repeatedly pushed you into falsifying claims, that’s a red flag. We know how to conduct a thorough investigation into how evidence was gathered. - Insufficient Evidence
The government must prove your guilt beyond a reasonable doubt. If we find holes in their paper trail, or question the authenticity of key evidence, we can push to dismiss or reduce the charges. In some scenarios, the government’s case depends on one main witness who lacks credibility or has a personal agenda. By exposing that, we can undermine the prosecution. - Procedural Errors
Federal agents often rely on warrants, subpoenas, and search protocols to build their case. If they collect evidence illegally—like searching your home or office without the proper warrant—we move to suppress that evidence. A single procedural slip can change the entire outcome. - Double Jeopardy Nuances
It’s true that double jeopardy prohibits you from being tried twice for the same offense by the same sovereign. But if you had a state prosecution for a related offense, the feds may still pursue charges. We evaluate every angle. If we see an opening to argue that the federal case is duplicating what happened in state court, we seize that opportunity.
Multiple Real Scenarios—Different Approaches
• The Overbilling Doctor: Suppose you’re a New York physician accused of billing Medicaid for procedures you didn’t perform. The government might rely on patient records, staff testimonies, and electronic billing data. Our approach: gather all medical charts, interview your billing service, and show where honest coding errors happened. We highlight that you had zero intent to deceive.
• The Broker Accused of Embezzlement: Maybe you’re an insurance broker collecting premiums across multiple states, and the feds claim you pocketed funds. Our defense: track each payment, demonstrate your back-end systems were flawed but not criminal. If there’s a timeline mismatch or a known glitch in the aggregator platform, we raise that issue immediately.
• The Corporate Executive: Some clients manage large insurance portfolios. If the government accuses you of orchestrating a scheme to defraud an entire plan, we dig into each transaction. We search for emails, transaction logs, or board minutes that show you acted under the belief your conduct was lawful.
Table: Defense Strategies at a Glance
| Defense Strategy | Example Scenario | Possible Outcome |
|---|---|---|
| Lack of Intent | Coding error in medical billing | Case dismissed or charges downgraded |
| Entrapment | Undercover agent pushing for false documents | Potential case dismissal if misconduct shown |
| Insufficient Evidence | Weak links to the alleged fraudulent scheme | Not guilty verdict or reduced charges |
| Procedural Errors | Illegal searches or coerced confessions | Key evidence suppressed, leading to dismissal |
Why Hiring a Skilled Federal Lawyer Matters
Federal prosecutors are incredibly driven. They often want a conviction that sends a deterrent message. That’s why hiring a lawyer who knows how to handle complex federal investigations is indispensable. At Spodek Law Group, we’ve handled cases involving major allegations, including high-profile clients like Anna Delvey (a.k.a Anna Sorokin). We’re known for thinking outside the box.
Competing Viewpoints—When Plea Deals Make Sense
We look at every path, including plea deals. Sometimes, if the evidence is solid, we can negotiate a plea that avoids worst-case scenarios like extended prison time. But if the government’s case has serious flaws, we’re not afraid to go to trial. Our role is to give you options, explain the risks, and fight for you every step of the way.
Practical Tips to Protect Yourself Right Now
• Preserve Records: Don’t alter or destroy documents. It can lead to obstruction charges.
• Avoid Unnecessary Chat: Politely decline to speak with investigators without counsel.
• Seek Legal Help Early: The sooner you call us, the better our chances of guiding the case before it escalates.
We’re Here 24/7
At Spodek Law Group, we pride ourselves on accessibility. If you or a loved one is dealing with a federal insurance fraud investigation, call us. We offer a risk-free consultation. That’s your opportunity to ask the tough questions. You can walk us through every detail. Our firm is here to build a personalized defense, one that pokes holes in the prosecution’s narrative and strives to get you the best possible outcome.